Dietary management has been considered an alternative means of modulating adiponectin levels. The purpose of this review is to examine the scientific evidence regarding the effect of diet on adiponectin levels in blood. Clinical trials were selected from Medline until April 2010 using the following MeSH terms: adipokines OR adiponectin AND diet OR lifestyle. A total of 220 articles were identified in the initial search, and 52 studies utilizing three different methods of dietary management were included in the present review: low-calorie diets (n = 9 studies), modification of diet composition (n = 33), and diet plus exercise (n = 10). Daily intake of fish or omega-3 supplementation increased adiponectin levels by 14-60%. Weight loss achieved with a low-calorie diet plus exercise increased adiponectin levels in the range of 18-48%. A 60-115% increase in adiponectin levels was obtained with fiber supplementation. In conclusion, dietary management can be an effective therapeutic means of increasing adiponectin levels. Studies investigating different forms of adiponectin and changes in the types of adipose tissue are necessary in order to elucidate the mechanisms involved in the modulation of adiponectin levels.

Background/Objectives: Dietary factors have been associated with metabolic syndrome (MS) in healthy individuals and specific ethnic groups. To evaluate possible associations of usual dietary factors with the presence of MS in patients with type 2 diabetes mellitus (DM). Subjects/Methods: In this cross-sectional study, 214 patients with type 2 DM without dietary counseling during previous 6 months were studied. After clinical and laboratory examinations, dietary intake was evaluated by 3-day weighed-diet records, whose reliability was confirmed by 24-h urinary nitrogen output. The presence of MS was defined according to International Diabetes Federation. Results: Patients with MS (n ¼ 174) had a lower intake of total (16.776.2 vs 19.576.5 g day À1 ; P ¼ 0.010) and soluble fibers (5.371.8 vs 6.072.7 g day À1 ; P ¼ 0.011) than patients without MS. In multiple logistic regression models, adjusted for gender and DM duration, variables associated with MS were soluble fibers (OR ¼ 0.86; 95% CI ¼ 0.74-0.98; P ¼ 0.046), soluble fibers from whole-grain foods (OR ¼ 0.43; 95% CI ¼ 0.25-0.76; P ¼ 0.002) and soluble fibers from fruits (OR ¼ 0.76; 95% CI ¼ 0.62-0.95; P ¼ 0.017). Whole-grain and fruits were the foods negatively associated with MS. Conclusions: The intake of soluble fibers, particularly from whole-grain foods and fruits, may have a protective role for the presence of MS in this selected sample of patients with type 2 DM.

Background:The amount and quality of carbohydrates are important determinants of plasma glucose after meals. Regarding fiber content, it is unclear whether the intake of soluble fibers from foods or supplements has an equally beneficial effect on lowering postprandial glucose. Objective: The aim of our study was to compare the acute effect of soluble fiber intake from foods or supplements after a common meal on postprandial plasma glucose and plasma insulin in patients with type 2 diabetes (T2D). Design: A randomized crossover clinical trial was conducted in patients with T2D. Patients consumed isocaloric breakfasts (mean 6 SD: 369.8 6 9.4 kcal) with high amounts of fiber from diet food sources (total fiber: 9.7 g; soluble fiber: 5.4 g), high amounts of soluble fiber from guar gum supplement (total fiber: 9.1 g; soluble fiber: 5.4 g), and normal amounts of fiber (total fiber: 2.4 g; soluble fiber: 0.8 g). Primary outcomes were postprandial plasma glucose and insulin (0-180 min). Data were analyzed by repeated measures ANOVA and post hoc Bonferroni test. Results: A total of 19 patients [aged 65.8 6 7.3 y; median (IQR), 10 (5-9) y of T2D duration; glycated hemoglobin 7.0% 6 0.8%; body mass index (in kg/m 2 ) 28.2 6 2.9] completed 57 meal tests. After breakfast, the incremental area under the curve (iAUC) for plasma glucose [mg/dL $ min; mean (95% CI)] did not differ between high fiber from diet (HFD) [7861 (6257, 9465)] and high fiber from supplement (HFS) [7847 (5605, 10,090)] (P = 1.00) and both were lower than usual fiber (UF) [9527 (7549, 11,504)] (P = 0.014 and P = 0.037, respectively). iAUCs [mIU/mL $ min; mean (95% CI)] did not differ (P = 0.877): HFD [3781 (2513, 5050)], HFS [4006 (2711, 5302), and UF [4315 (3027, 5603)]. Conclusions: Higher fiber intake was associated with lower postprandial glucose at breakfast, and the intake of soluble fiber from food and supplement had a similar effect in patients with T2D. This trial was registered at clinicaltrials.gov as NCT02204384.Am J Clin Nutr 2017;106:1238-45.

OBJECTIVE -To determine the fatty acid composition of serum phospholipid, triglyceride, and cholesterol ester fractions and to analyze the lipid profile of microalbuminuric type 2 diabetic patients. RESEARCH DESIGN AND METHODS-A case-control study was conducted with 72 patients: 37 were normoalbuminuric (urinary albumin excretion rate [UAER] Ͻ20 g/min), and 35 were microalbuminuric (UAER 20 -200 g/min). After 4 weeks of a standardized diet, the fatty acid composition of phospholipid, triglyceride, and cholesterol ester fractions was determined by gas chromatography. Total cholesterol and triglycerides were measured by enzymaticcolorimetric methods; cholesterol HDL by double precipitation with heparin, MnCl 2 , and dextran sulfate; and apolipoprotein B by immunoturbidimetry.RESULTS -Microalbuminuric patients showed a lower proportion of polyunsaturated fatty acids (24.8 Ϯ 11.0%), especially of the n-6 family (21.7 Ϯ 10.5%), in triglyceride fraction than normoalbuminuric patients (34.1 Ϯ 11.3%, P ϭ 0.001 and 31.4 Ϯ 11.5%, P Ͻ 0.001, respectively). Patients with microalbuminuria also presented higher levels of saturated fatty acids in triglyceride fraction (43.4 Ϯ 18.0% vs. 34.7 Ϯ 13.1%, P ϭ 0.022). In the logistic regression analysis, only the proportion of polyunsaturated fatty acids in triglyceride fraction remained significantly associated with microalbuminuria (odds ratio [OR] 0.92, 95% CI 0.85-0.98, P ϭ 0.019). Total cholesterol, HDL cholesterol, triglyceride, and apolipoprotein B levels were similar in normo-and microalbuminuric patients.CONCLUSION -Microalbuminuria in type 2 diabetic patients is associated with low polyunsaturated fatty acid contents in serum triglyceride fraction. This association may represent a risk factor for cardiovascular disease and may contribute to the progression of renal disease. Diabetes Care 26:613-618, 2003M icroalbuminuria is known to be an independent risk factor for cardiovascular death in type 2 diabetic patients (1,2), but the mechanisms underlying this association have not been clarified. It could be that other cardiovascular risk factors that are frequently associated with microalbuminuria, such as hyperglycemia, hypertension (3), and endothelial dysfunction (4), might also contribute to the increased cardiovascular mortality observed in these patients. In addition, dyslipidemia has also been described in type 2 diabetic patients with microalbuminuria (2,5,6). Although those studies did not specifically assess the effect of nutrient intake, the effect of dietary habits on the development of dyslipidemia in these microalbuminuric patients cannot be ruled out.Dietary habits influence serum lipid levels and renal function in patients with diabetes. For example, higher intake of fish protein has been shown to be related to a lower risk for microalbuminuria in type 1 diabetic patients (7), and replacement of red meat with chicken reduces albumin excretion rate and serum cholesterol levels in microalbuminuric type 2 diabetic patients (8). These effects may result from the hig...

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AimThis cross-sectional study aimed to assess the association of the fat content in the diet with Diabetic Kidney Disease (DKD) in patients with type 2 diabetes.MethodologyPatients from the Diabetes research clinic at Hospital de Clínicas de Porto Alegre (Brazil) were consecutively recruited. The inclusion criterion was the diagnosis of type 2 diabetes. The exclusion criteria were as follows: body mass index >40 kg/m2, heart failure, gastroparesis, diabetic diarrhea, dietary counseling by a registered dietitian during the previous 12 months, and inability to perform the weighed diet records (WDR). The dietary fatty acids (saturated, monounsaturated and polyunsaturated) consumption was estimated by 3-day WDR. Compliance with the WDR technique was assessed by comparison of protein intake estimated from the 3-day WDR and from the 24-h urinary nitrogen output performed on the third day of the WDR period. The presence of DKD was defined as urinary albumin excretion (UAE) ≥ 30 mg / 24 h or/and glomerular filtration rate (eGFR) <60 ml/min/1.73 m2. Urinary albumin was measured twice and eGFR was estimated by using the CKD-EPI equation.ResultsA total of 366 patients were evaluated; of these, 33% (n = 121) had DKD. Multivariate analysis showed that the intake of linolenic acid was negatively associated with DKD (OR = 0.57; 95% CI 0.35–0.93; P = 0.024), adjusted for gender, smoking, cardiovascular disease, ACE inhibitors and/or angiotensin receptor blocker use, systolic blood pressure, fasting plasma glucose and HDL cholesterol. In a separate model, similar results were observed for linoleic acid, adjusting to the same co-variables (OR = 0.95; 95% CI 0.91–0.99; P = 0.006).ConclusionThe lower intake of polyunsaturated fatty acids, especially linolenic and linoleic acid, is associated with chronic kidney disease in patients with type 2 diabetes.

In type 2 diabetic patients, the high intake of protein and the low intake of PUFAs, particularly from plant oils, were associated with the presence of microalbuminuria. Reducing protein intake from animal sources and increasing the intake of lipids from vegetable origin might-reduce the risk of microalbuminuria.

Different dietary interventions have been identified as potential modifiers of adiponectin concentrations, and they may be influenced by lipid intake. We identified studies investigating the effect of dietary lipids (type/amount) on adiponectin concentrations in a systematic review with meta-analysis. A literature search was conducted until July 2013 using databases such as Medline, Embase and Scopus (MeSH terms: 'adiponectin', 'dietary lipid', 'randomized controlled trials (RCT)'). Inclusion criteria were RCT in adults analysing adiponectin concentrations with modification of dietary lipids. Among the 4930 studies retrieved, fifty-three fulfilled the inclusion criteria and were grouped as follows: (1) total dietary lipid intake; (2) dietary/supplementary n-3 PUFA; (3) conjugated linoleic acid (CLA) supplementation; (4) other dietary lipid interventions. Diets with a low fat content in comparison to diets with a high-fat content were not associated with positive changes in adiponectin concentrations (twelve studies; pooled estimate of the difference in means: 20·04 (95 % CI 2 0·82, 0·74) mg/ml). A modest increase in adiponectin concentrations with n-3 PUFA supplementation was observed (thirteen studies; 0·27 (95 % CI 0·07, 0·47) mg/ml). Publication bias was found by using Egger's test (P¼ 0·01) and funnel plot asymmetry. In contrast, CLA supplementation reduced the circulating concentrations of adiponectin compared with unsaturated fat supplementation (seven studies; 20·74 (95 % CI 21·38, 2 0·10) mg/ml). However, important sources of heterogeneity were found as revealed by the meta-regression analyses of both n-3 PUFA and CLA supplementation. Results of new RCT would be necessary to confirm these findings.